Archived: Maitland Terrace

Updated 7 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 and 23 April 2018 and was unannounced. This meant the provider was not aware we intended to carry out an inspection. The inspection was undertaken by one inspector.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we held about the provider, in particular, notifications about incidents, accidents, safeguarding matters and any deaths. We contacted the local authority prior to the inspection for any information they held about the home. We used their comments to support our planning of the inspection.

People using the service were not always able to communicate with us in detail, but we observed they looked happy and relaxed. We spoke with two members of staff, the interim manager, the recently appointed manager and the regional manager. During the inspection we also spoke with a member of the local authority Deprivation of Liberty Safeguards team.

We reviewed a range of documents and records including; four care records for people who used the service, five medicine administration records, five records of staff employed at the home, accidents and incident records, fire records, training records, minutes of meetings, communication documents and a range of other quality audits and management records.

Updated 7 June 2018

This inspection took place on 17 and 23 April 2018 and was unannounced. A previous inspection, undertaken in February 2017, found the provider in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and rated the service as ‘Requires Improvement’ overall.

Maitland Terrace is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide support for up to seven people over single storey, bungalow style accommodation. Residential care is provided for people with a learning disability, physical disability or those with an autistic type condition. Nursing care is not provided at the home. On both days of the inspection there were six people using the service.

At the time of the inspection there was no registered manager formally registered at the home. The previous registered manager had left the home and cancelled their registration in January 2018. A new manager had been appointed but had been in post only around two weeks. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. We were supported on the inspection by the interim manager who had been over seeing the service and the provider’s regional manager.

Staff were aware of safeguarding issues and told us they would report any concerns around potential abuse. Any safeguarding matters had been appropriately investigated and dealt with.

Checks were carried out on the equipment and safety of the home. Previous concerns around fire safety at the home had been addressed. Staff had completed fire safety training and regular fire drills were undertaken. Risk assessments linked to people’s care were not always updated in a timely manner and care plans did not always fully reflect the advice given by health professionals. The home was maintained in a clean and tidy manner.

Staff told us they felt there were enough staff at the home and said they were able to accompany people to access the community and support them with their personal care needs. Proper recruitment procedures and checks were in place to ensure staff employed by the service had the correct skills and experience. Previous issues with regard to the safe management of medicines had been addressed and we found no issues.

Staff told us they had access to a range of training and there was good overall uptake of training provided. Staff confirmed that had access to regular supervision and had been offered an annual appraisal.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’ it also ensures unlawful restrictions are not placed on people in care homes and hospitals. Appropriate applications for DoLS had been made and there was evidence best interests decisions had been made, when appropriate.

People had access to health care services to help maintain their physical and psychological wellbeing. People were supported to access adequate levels of food and drink.

At the previous inspection we had noted the decoration of the home was in need of updating and some areas of the kitchen facilities were damaged and required replacement. To date this work had not been completed. The regional manager informed us this work was to be undertaken in the near future.

We observed there to be good relationships between people and staff. People looked happy and relaxed in staff company. Staff displayed an exceptional understanding of people as individuals and of treating them with dignity and respect. We found limited evidence to suggest that people, or their legal representatives, had been actively involved in their care reviews. Reviews of care were often limited in content and information.

People’s needs had been assessed and individualised care plans and risk assessments developed that addressed identified needs. Some care plans had detailed information for care staff to follow. Other care plans lacked specific detail about how to support people. Reviews of care plans were not always timely, detailed or appropriately recorded. People were supported to attend various events and activities in the local community. Activities also took place within the home and people clearly enjoyed these. There had been no formal complaints in the last year.

Regular checks and audits were carried out on the service by senior staff within the organisation. Whilst the range of checks and audits had improved, there continued to be issues identified at this inspection that had not been identified through these quality processes. Staff were positive about the interim manager and the support they received from the regional manager. They said there was a good staff team and felt well supported by colleagues. Daily records at the home were limited in detail and were not always person centred.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to the Safe care and treatment, Person–centred care and Good governance. You can see what action we told the provider to take at the back of the full version of the report.